双胎妊娠早产危险因素的临床分析

摘要

目的:探讨双胎妊娠早产的发生情况及可能的危险因素.方法:回顾性分析2016年1 ～12月于首都医科大学附属北京妇产医院分娩的343例双胎妊娠病例的临床资料,其中早产组170例,足月产组173例,分析引起双胎妊娠早产的可能影响因素.结果:早产组平均分娩孕周、剖宫产率、第一胎头先露比例、两胎儿平均出生体质量、1分钟及5分钟Apgar评分显著低于足月产组,而单绒毛膜性比例及新生儿窒息比例显著高于足月产组,差异有统计学意义(P＜0.05).Logistic回归分析显示,单绒毛膜性、胎膜早破、妊娠期高血压疾病(HDCP)及瘢痕子宫是双胎妊娠早产的危险因素(P＜0.05).结论:早产与胎儿绒毛膜性、胎膜早破、HDCP及瘢痕子宫等多种因素密切相关,对合并高危因素的双胎妊娠需要高度重视,在加强孕期监护同时,应依据风险因素制定个体化干预措施,以确保母婴安全、减少新生儿窒息与死亡.%Objective:To investigate the incidence and risk factors of preterm twin pregnancy.Methods:343 twin-pregnant women delivered in Beijing Obstetrics and Gynecology Hospital from January 2016 to December 2016 were analyzed retrospectively,including 170 preterm twins and 173 term twins.Results:In the preterm group,mean gestational weeks,the rates of cesarean section and vertex twins,mean birth weight,1 min and 5 min Apgar scores were significantly lower compared with the control group(P ＜ 0.05).Multiple factors Logistic regression analysis demonstrated that monochorionic twins,premature rupture of membranes,hypertensive disorder complicating pregnancy and cicatrical uterus were risk factors of preterm twin pregnancy.Conclusions:Preterm birth in twin pregnancy is in correlation with many risk factors,such as chorionicity,premature rupture of membranes,hypertensive disorder complicating pregnancy and cicatricaluterus.Prenatal care and individualized intervening measures should be strengthened to improve maternal and neonatal outcomes.